THE lyme disease is caused by a bacterium , Borrelia burgdorferitransmitted by ticks of the genus Ixodes.
Although cases of the disease are concentrated in certain endemic areas, foci of Lyme disease are widely distributed in the United States, Europe and Asia. In Brazil, the states of São Paulo, Santa Catarina, Rio Grande do Norte and Amazonas have reported isolated cases, according to the Ministry of Health.
This week, the Canadian singer Justin bieber , 28, announced a postponement of shows due to health conditions. In 2020, Bieber revealed he suffers from Lyme disease . Singer Avril Lavigne, 37, who also lives with the disease, revealed the diagnosis in 2015.
Signs include small, reddened skin lesions at the site of the tick bite, which may increase in size. The sign is an important clinical marker for diagnostic suspicion and alerts for epidemiological surveillance. As the area expands to 15 cm (limits from 3 to 68 cm), the lesion assumes a ring-like, warm and rarely painful characteristic.
The disease can also lead to symptoms such as malaise, fever, headache, neck stiffness, muscle aches, joint pain and swollen lymph nodes. Signs and symptoms can last for several weeks, especially in untreated cases.
Risks of complications
The main complications of Lyme disease are neurological, cardiac and joint aggravations.
Untreated individuals may present with neurological manifestations (15% of cases), such as aseptic meningitis, inflammation of the brain (encephalitis), chorea (repetitive, brief and irregular involuntary movements) and facial paralysis.
According to the Ministry of Health, about 8% of patients develop cardiac involvement with cardiac arrhythmia, inflammation of the heart muscle (myopericarditis) and evidence of dysfunction in blood pumping.
Within weeks to two years of disease onset, about 60% of patients may develop arthritis, usually characterized by intermittent bouts of joint swelling and pain.
Disease transmission and diagnosis
Lyme disease is transmitted from the tick nymphs bite , which stick to the skin in search of blood for 24 hours or more. THE disease is not transmitted through person-to-person contact and transmission from mother to baby during pregnancy is uncommon, according to the Ministry of Health.
The incubation period ranges from 3 to 32 days (on average, 7 to 14 days) and ranges from exposure to the tick to the appearance of the skin lesion. Patients who do not have the skin lesion in the initial phase can still manifest the symptom years later.
Diagnosis of Lyme disease is based on the identification of clinical features of the disease in patients who report possible exposure to tick bites associated with laboratory tests.
The bacteria causing the disease can be identified from the laboratory analysis performed from the collection of a sample of the skin lesion. Although definitive, the method is not so accurate due to the difficulty in identifying the bacteria in the samples.
Serology tests are the most used methods for diagnosis. In general, disease-specific antibodies can peak between 3 and 6 weeks. The lack of standardization regarding the techniques increases the caution regarding the interpretation of the tests. Patients who receive early treatment may have negative serology, for example.
Treatment
Because it is a disease caused by bacteria, treatment is carried out with the use of antibiotics. According to the Ministry of Health, the drugs recommended for the treatment of adults are doxycycline and amoxicillin. For children under 9 years of age, amoxicillin should be used.
In patients with neurological manifestations, penicillin or ceftriaxone may be used. For penicillin-allergic individuals, erythromycin should be used.
Disease surveillance and control
As it is a rare disease in Brazilian territory, it is characterized as an unusual condition, and therefore requires compulsory notification and mandatory investigation.
Epidemiological surveillance aims to detect suspected or confirmed cases, aiming at the early initiation of treatment to avoid complications. Monitoring also seeks to identify outbreaks, through investigation, so that health education measures are carried out to reduce the risk of new infections.
According to the Ministry of Health, epidemiological investigation measures include the active search for cases and verification of the extent of the area where the transmitting ticks are present.
Disease control also considers health education actions on the transmission cycle, with guidelines for residents and workers in affected areas for prevention measures.
Prevention
Care includes the use of light, long-sleeved clothing, use of repellents on uncovered parts of the skin and on the edges of clothing. In addition to frequent observation of the skin, looking for the presence of ticks.
The removal of ticks must be done with protected hands (gloves or plastic bags) and gently use tweezers. It must be avoided that the tick is crushed or that part of it remains adhered to the skin. The ministry does not recommend isolation of patients.
Source: CNN Brasil
